Taxes may pay for new Fair Deal

Increased corporation tax revenues should be used to fund a new €100m Fair Deal scheme for home care, a report has recommended.

The report, due to be published by the Government this week, put forward a wide range of suggestions on how home care should be delivered and also calls for a standardisation of the provision and access to services.

It is expected that there will be nearly 1m people over the age of 65 in Ireland by 2031, so the funding of health services, nursing home care, and home help packages will have to increase significantly to meet demand.

Using increased revenues collected from corporation tax is one of the main proposals put forward to fund a better homecare system in this country, which was described as “ad hoc, piecemeal, fragmented” by one contributor to the report.

Other funding ideas presented include a universal national care system paid for through taxation; a social insurance model; and co-financing between the State and means-tested contributions from the individual.

Health Minister Simon Harris and the minister of state for older people, Jim Daly, have already signalled that a new scheme modelled on Fair Deal is needed to support older people to stay in their homes. However, this is likely to take between two and three years to establish.

The Institute of Public Health in Ireland report analysed the responses to the Department of Health consultation into the future of home care policy. The findings will now advise Government on the financing and regulation of home care.

More than 2,600 submissions from groups including Age Action, the Alzheimer Society of Ireland, Beaumont Hospital, Family Carers Ireland, Hiqa, the INMO, and Irish Rural Link as well as members of the public were received.

There was agreement that resources allocated to home care are insufficient, and users’ needs should determine the level of ring-fenced investment in services.

A significant number of submissions emphasised the need for increased investment in home care services, with an advocacy body stating that, despite the growth in the population between 2006 and 2015, the allocation of exchequer funding for home care declined during this period, resulting in a shortfall of 10% by 2015.

Another advocacy group said that funding in excess of €100m is required “at a minimum” to bring core community services for home care packages, home help, and residential care supports through the Fair Deal scheme to more sustainable levels.

However, 57% of respondents said that some contribution should be made towards home care by elderly people themselves.

There were a wide range of views on how means testing would work, including via a minimum threshold beneath which service users would not pay for home care.

But it was suggested that means-tested user contributions could only be legitimately introduced if the service provided was comprehensive and of a high quality, and as long as if service users were given a choice of carer and influence over the services provided.

It has also suggested that carers should have a minimum level of training.

Citing investments in childcare and early childhood education, which have increased the level of training for those who work in creches, the report suggests a similar model needs to be developed for the home care and long-term care sector.

One care home provider said the workforce needs to increase by 48% just to meet demographic growth over the next 10 years. The introduction of a Single Assessment Tool was viewed by professional bodies and organisations as integral to the home care system.

Over 90% of respondents called for a standard application process and said a standardised nationwide approach to how home care is provided and who can access it should also be adopted.